Asthma
Sunday 30 December 2012
Tuesday 18 December 2012
How Can Asthma Be Prevented?
You can’t prevent asthma. However, you can take steps to
control the disease and prevent its symptoms. For example:
- Learn
about your asthma and ways to control it.
- Follow
your written asthma action plan. (For a sample plan, go to the National
Heart, Lung, and Blood Institute's "Asthma
Action Plan.")
- Use
medicines as your doctor prescribes.
- Identify
and try to avoid things that make your asthma worse (asthma triggers).
However, one trigger you should not avoid is physical activity. Physical
activity is an important part of a healthy lifestyle. Talk with your
doctor about medicines that can help you stay active.
- Keep
track of your asthma symptoms and level of control.
- Get
regular checkups for your asthma.
How Is Asthma Treated and Controlled?
Asthma is a long-term disease that has no
cure. The goal of asthma treatment is to control the disease. Good asthma
control will:
- Prevent chronic and troublesome
symptoms, such as coughing and shortness of
breath
- Reduce your need for quick-relief
medicines (see below)
- Help you maintain good lung
function
- Let you maintain your normal
activity level and sleep through the night
- Prevent asthma attacks that could
result in an emergency room visit or hospital stay
To control asthma, partner with your doctor
to manage your asthma or your child's asthma. Children aged 10 or older—and
younger children who are able—should take an active role in their asthma care.
Taking an active role to control your
asthma involves:
- Working with your doctor to treat
other conditions that can interfere with asthma management.
- Avoiding things that worsen your
asthma (asthma triggers). However, one trigger you should not avoid is
physical activity. Physical activity is an important part of a healthy
lifestyle. Talk with your doctor about medicines that can help you stay
active.
- Working with your doctor and other
health care providers to create and follow an asthma action plan.
An asthma action plan gives guidance on
taking your medicines properly, avoiding asthma triggers (except physical
activity), tracking your level of asthma control, responding to worsening
symptoms, and seeking emergency care when needed.
Asthma is treated with two types of
medicines: long-term control and quick-relief medicines. Long-term control
medicines help reduce airway inflammation and prevent asthma symptoms.
Quick-relief, or "rescue," medicines relieve asthma symptoms that may
flare up.
Your initial treatment will depend on the
severity of your asthma. Followup asthma treatment will depend on how well your
asthma action plan is controlling your symptoms and preventing asthma attacks.
Your level of asthma control can vary over
time and with changes in your home, school, or work environments. These changes
can alter how often you're exposed to the factors that can worsen your asthma.
Your doctor may need to increase your
medicine if your asthma doesn't stay under control. On the other hand, if your
asthma is well controlled for several months, your doctor may decrease your
medicine. These adjustments to your medicine will help you maintain the best
control possible with the least amount of medicine necessary.
Asthma treatment for certain groups of
people—such as children, pregnant women, or those for whom exercise brings on
asthma symptoms—will be adjusted to meet their special needs.
Follow
an Asthma Action Plan
You can work with your doctor to create a
personal asthma action plan. The plan will describe your daily treatments, such
as which medicines to take and when to take them. The plan also will explain
when to call your doctor or go to the emergency room.
If your child has asthma, all of the people
who care for him or her should know about the child's asthma action plan. This
includes babysitters and workers at daycare centers, schools, and camps. These
caretakers can help your child follow his or her action plan.
Go to the National Heart, Lung, and Blood
Institute's (NHLBI's) "Asthma
Action Plan" for
a sample plan.
Medicines
Your doctor will consider many things when
deciding which asthma medicines are best for you. He or she will check to see
how well a medicine works for you. Then, he or she will adjust the dose or
medicine as needed.
Asthma medicines can be taken in pill form,
but most are taken using a device called an inhaler. An inhaler allows the
medicine to go directly to your lungs.
Not all inhalers are used the same way. Ask
your doctor or another health care provider to show you the right way to use
your inhaler. Review the way you use your inhaler at every medical visit.
Long-Term Control Medicines
Most people who have asthma need to take
long-term control medicines daily to help prevent symptoms. The most effective
long-term medicines reduce airway inflammation, which helps prevent symptoms
from starting. These medicines don't give you quick relief from symptoms.
Inhaled corticosteroids. Inhaled
corticosteroids are the preferred medicine for long-term control of asthma.
They're the most effective option for long-term relief of the inflammation and
swelling that makes your airways sensitive to certain inhaled substances.
Reducing inflammation helps prevent the
chain reaction that causes asthma symptoms. Most people who take these
medicines daily find they greatly reduce the severity of symptoms and how often
they occur.
Inhaled corticosteroids generally are safe
when taken as prescribed. These medicines are different from the illegal
anabolic steroids taken by some athletes. Inhaled corticosteroids aren't
habit-forming, even if you take them every day for many years.
Like many other medicines, though, inhaled
corticosteroids can have side effects. Most doctors agree that the benefits of
taking inhaled corticosteroids and preventing asthma attacks far outweigh the
risk of side effects.
One common side effect from inhaled
corticosteroids is a mouth infection called thrush. You might be able to use a
spacer or holding chamber on your inhaler to avoid thrush. These devices attach
to your inhaler. They help prevent the medicine from landing in your mouth or
on the back of your throat.
Check with your doctor to see whether a
spacer or holding chamber should be used with the inhaler you have. Also, work
with your health care team if you have any questions about how to use a spacer
or holding chamber. Rinsing your mouth out with water after taking inhaled
corticosteroids also can lower your risk for thrush.
If you have severe asthma, you may have to
take corticosteroid pills or liquid for short periods to get your asthma under
control.
If taken for long periods, these medicines
raise your risk for cataracts and osteoporosis (OS-te-o-po-RO-sis). A cataract
is the clouding of the lens in your eye. Osteoporosis is a disorder that makes
your bones weak and more likely to break.
Your doctor may have you add another
long-term asthma control medicine so he or she can lower your dose of
corticosteroids. Or, your doctor may suggest you take calcium and vitamin D
pills to protect your bones.
Other long-term control medicines. Other
long-term control medicines include:
- Cromolyn. This medicine
is taken using a device called a nebulizer. As you breathe in, the
nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps
prevent airway inflammation.
- Omalizumab (anti-IgE). This
medicine is given as a shot (injection) one or two times a month. It helps
prevent your body from reacting to asthma triggers, such as pollen and
dust. Anti-IgE might be used if other asthma medicines have not worked
well.
- Inhaled
long-acting beta2-agonists. These
medicines open the airways. They might be added to low-dose inhaled
corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists
should never be used for long-term asthma control unless they're used with
inhaled corticosteroids.
- Leukotriene
modifiers. These
medicines are taken by mouth. They help block the chain reaction that
increases inflammation in your airways.
- Theophylline. This medicine
is taken by mouth. Theophylline helps open the airways.
If your doctor prescribes a long-term
control medicine, take it every day to control your asthma. Your asthma
symptoms will likely return or get worse if you stop taking your medicine.
Long-term control medicines can have side
effects. Talk with your doctor about these side effects and ways to reduce or
avoid them.
With some medicines, like theophylline,
your doctor will check the level of medicine in your blood. This helps ensure
that you’re getting enough medicine to relieve your asthma symptoms, but not so
much that it causes dangerous side effects.
Quick-Relief Medicines
All people who have asthma need
quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are
the first choice for quick relief.
These medicines act quickly to relax tight
muscles around your airways when you're having a flareup. This allows the
airways to open up so air can flow through them.
You should take your quick-relief medicine
when you first notice asthma symptoms. If you use this medicine more than 2
days a week, talk with your doctor about your asthma control. You may need to
make changes to your asthma action plan.
Carry your quick-relief inhaler with you at
all times in case you need it. If your child has asthma, make sure that anyone
caring for him or her has the child's quick-relief medicines, including staff
at the child's school. They should understand when and how to use these
medicines and when to seek medical care for your child.
You shouldn't use quick-relief medicines in
place of prescribed long-term control medicines. Quick-relief medicines don't
reduce inflammation.
Avoid Things That Can Worsen Your Asthma
Many common things (called asthma triggers)
can set off or worsen your asthma symptoms. Once you know what these things
are, you can take steps to control many of them. (For more information about
asthma triggers, go to "What
Are the Signs and Symptoms of Asthma?")
For example, exposure to pollens or air
pollution might make your asthma worse. If so, try to limit time outdoors when
the levels of these substances in the outdoor air are high. If animal fur
triggers your asthma symptoms, keep pets with fur out of your home or bedroom.
One possible asthma trigger you shouldn’t
avoid is physical activity. Physical activity is an important part of a healthy
lifestyle. Talk with your doctor about medicines that can help you stay active.
The NHLBI offers many useful tips for
controlling asthma triggers. For more information, go to page 2 of NHLBI's "Asthma Action Plan."
If your asthma symptoms are clearly related
to allergens, and you can't avoid exposure to those allergens, your doctor may
advise you to get allergy shots.
You may need to see a specialist if you're
thinking about getting allergy shots. These shots can lessen or prevent your
asthma symptoms, but they can't cure your asthma.
Several health conditions can make asthma
harder to manage. These conditions include runny nose, sinus infections, reflux
disease, psychological stress, and sleep apnea.
Your doctor will treat these conditions as well.
Diagnostic Tests
Lung Function Test
Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working.
This test measures how much air you can breathe in and out. It also measures
how fast you can blow air out.
Your doctor may give you medicine and then
retest you to see whether the results have improved.
If your test results are lower than normal
and improve with the medicine, and if your medical history shows a pattern of
asthma symptoms, your doctor will likely diagnose you with asthma.
Other Tests
Your doctor may recommend other tests if he
or she needs more information to make a diagnosis. Other tests may include:
- Allergy testing to find out which
allergens affect you, if any.
- A test to measure how sensitive
your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun)
test. Using spirometry, this test repeatedly measures your lung function
during physical activity or after you receive increasing doses of cold air
or a special chemical to breathe in.
- A test to show whether you have
another condition with symptoms similar to asthma, such as reflux disease,
vocal cord dysfunction, or sleep apnea.
- A chest
x ray or an EKG (electrocardiogram).
These tests will help find out whether a foreign object in your airways or
another disease might be causing your symptoms.
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